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1.3 329 Reviews

Humana Complaints Summary

26 Resolved
302 Unresolved
Our verdict: If considering services from Humana with a critical resolution rate, extra caution is advised. Examine detailed customer feedback to understand the severity and nature of unresolved issues. Be prepared for the possibility of unsatisfactory responses and have contingency plans, including seeking assistance from consumer advocacy groups if necessary.
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Humana reviews & complaints 329

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L
9:49 am EDT
Verified customer This complaint was posted by a verified customer. Learn more

Humana Health nurse that comes to the house - trina is her name

I trusted Trina to answer questions we had to better John's life. But from what I'm hearing, she's pissed off that I'm the caretaker and she thinks she should be the caretaker. I will not put up with this and I ask that you take her off this address so she won't return. She is only a nurse that visits, over the phone because of virus, and she don't have a right to act this way. We do not want her back. If John Minor has to have a nurse, then pick someone else. I will continue being his caretaker and that's just the way it is. I request this issue taken care of. Thank you.

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4:20 pm EDT
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Humana Medicare insurance

One adding point to my earlier suggestions:

I do not know details how Medical insurance pays to doctors. If Humana pays to them way lower than usual as Dr. Gorokhov said to me earlier, you might need to review your pay schedule. For appealing to upper class of physicians to serve in Humana network and to maintain them in its team, Humana will need to raise its level to pay for them. And so, Medicare / Humana covered patients would receive at least an equal treatment in health cares to that offered to others; not that provided for secondary citizens; such as that they only see nurses when they go for doctors. To adjust payments for doctors will certainly raise your costs, which may be offset by reducing the budget for advertisements and many extra benefits offered to customers. For cutting back these costs, Humana may take leadership to work out with businesses in the field to limit many of unnecessary spending caused by corporate competitions. It's great and welcome that Humana endows many side advantages to its insured customers. However, for me and perhaps for many others, we would rather to receive safer and higher quality of health cares insured by Medicare than to attend to many inessential commercial appeals.

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Update by Chih Wang
Aug 31, 2020 2:32 pm EDT

My wife, Kwei-Yung and I have been with Humana for several years. We appreciate your services and many benefits you provided to us. However, in recent years, I have had a few issues with Humana, which I am submitting here for your review.
With Humana insurance cover, I have Dr. Donald Bohne in Tucker, GA do dental clean for several years, for which I was very satisfied with the work of his staff. In 2018, I went there as usual and had my dental cleaned. Then sometime in 2019, I received a bill from the dental office, stating that Humana would not cover the costs. To resolve the issue, I negotiated with the dental office and paid it $100. At that time, I learned that Humana had cut out Dr. Bohne off his service. The reason that he was cut off from Humana network might relate to his higher charges of services. Yes, Dr. Bohne and I should have checked with insurance before we gave and took the work. However, the payment issue would be avoided should Humana have provided us, especially me, an early notice in the beginning of the year that Dr. Bohne was no longer in Humana network.
In 2019, Humana offered an amount of money to help customers acquire hearing aids. I tried to take advantage of it and arranged with Optical (if my recall is correct) to obtain the aids. Optical referred me to Advanced Hearing Center, which sold me a pair of them. Later, I returned them to the Center because they did not work for me. During the process, once I called Humana for questions and my phone was forwarded to Optical. Surprising or no surprising, Humana subcontracted the work to a company and sat there to earn commissions. It was a good business practice. And I figured out that I could easily buy a pair of hearing aids with a similar price without Humana insurance allowance.
In July 2020, I called Dr. Mikhail Gorokhov, my primary physician, in Lavista Family Medicine, requesting for an appointment. For a little while, I was told that Dr. Gorokhov had quitted from Humana network. My wife, Kwei-Yung, was also one of the patients of the clinic. Both of us would have to find other primary doctors. When I visited him in 2019, once I had a little chat with Dr. Gorokhov. He was not very happy with me at the time, saying Humana did not pay him very much. As I could recall, he had said the similar words to me before. Fortunately, my wife and I were going on normally during January to July, 2020. We would have HUGE troubles if we had an emergence, hospitalized, and found out that we did not have primary doctors. Yes, it should have been the customers' responsibility to keep alert on the changes of their health insurance. However, it would be a courtesy and a normal procedure that an insurance company ought to notify its customers when their regular doctors were removed from its network.
Alerting to the urgent for without family doctors, I immediately looked into Humana 2020 Provider Directory in July this year, identified one, and made an appointment to see him for my wife and myself, intending to connect his service first. Two days before the appointment, I went online to check the background of the doctor selected from Humana list. In review section, I read a long list of negative comments on the doctor's office, not necessarily related to the identified doctor himself. I had no choice but cancelled the appointment.
Next day, I made a new appointment for my wife and me to see Dr. John M. Read III, who was also selected from Humana list. When we went to see him in Georgia Clinic, Tucker, we met Lily Phan, FNP, a nurse. Dr. Read was retired earlier. We went back a second time and saw another nurse; Ms. Phan was no longer there. Later, we received Humana insurance ID cards, where prints Onkar Kaur as primary physician. However, it seems to me that from now on, we will not see him at all. but the nurse only in this clinic.
This is new to us that we went to see a doctor but only met a nurse. If I could assume as Dr. Gorokhov had said to me twice, Medicare / Humana insurance does not pay doctors much, so instead to provide qualified physicians, Georgia Clinic hires a nurse independently to run the facility and serve its patients. If it is true, my wife and I covered by Medicare patients then fall into secondary citizens, who deserve only to have nurse not physician services. But we had paid health insurance premiums to Medicare during our work life.
At the end, if I could have a few humble inputs to Humana:
1. Please notify insured customers early when their ongoing physicians are cut off from Humana service network. Keep Humana Provider Directory updated and send to customers changes of providers during the year when needed.
2. Ask customers to evaluate their doctors and send results to Humana for its review before it compiles its annual Directory so that the list would be a more reliable selection source.
3. If nurses can substitute physicians as independent primary care givers, please list them as such; not list names of physicians, but in actuality, patients only
see nurses. When the list in the provider directory clearly identified, customers will have their free choices of care providers.

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10:21 pm EDT

Humana insurance coverage

was not explained to me and ended up paying 3000 dollars. I was told today that the Advantage plan would take the place of Medicare and I am responsible for the balance which is 20% is up to me to pay. Was not explained when I signed up. RIP OFF

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4:11 pm EDT
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Humana Insurance

I received a collections notice from an urgent care center because I was given false information on my health care coverage. Two weeks ago the first person told me that urgent care visits were free and that he would coordinate with the center to remove the bill (after telling me to pay the overcharged amount and I refused). I was hung up on when I tried to resolve the issue a second time. Humana only cares about their shareholders.

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1:43 pm EDT

Humana Trying to order stuff online

I trying to order stuff on line and keep getting the below area then I asked to talk to a someone that can help and I get hung up.

Dave
Cell: [protected]

Our apologies, we're having technical issues with our website. Please try again. If the problem continues for more than 24 hours, please call [protected](TTY: 711). We apologize for the inconvenience.

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11:57 am EDT

Humana Insurance & provider/group

Humana Advantage Gold covers one of the smallest geographic areas (only your zip code) & thus fewest physician choices I've seen. The Dr's. group which I chose Provided dilatory response & took more than 6 wks to finally get back to me. The response offered neither an apology, answer to the very few?'s I'd posed. & cavalierly told me to start over. The height of avoiding responsibiity. This would have, in turn, created a great burden & financial hardship for me. They still have not answered a follow up email of mine requesting the names of the practice manager & head of the Dr.'s group so they are made aware of the holes in their system in order that remedies are put in place

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4:39 pm EST
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Humana Misrepresentation of 0 pay plan

I subscribed to Humana's 0 pay plan: H45184153 with Marciel Lee (a knowledgeable licensed insurance producer). I was told that 0 pay is 0 pay and I agree with him. I recently got a report from Humana stating that I had a $7 co-pay? No one told me there was any co-pay on the 0 pay plan and the accupuncture center assurred me that there was NO copay and that Humana never told them there was...they were paid the accupuncture bill submitted. I called Humana who told me that the 0 pay plan included a co-pay but this makes No sense? 0 pay is 0 pay! Even Marciel told me 0pay is 0 pay. Why is Humana doing this leaving me confused and misinformed? Next year I will leave Humana and enroll in a plan that has 0pay and no copay.

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6:16 pm EST

Humana Dental

Humana is the worst! We've been paying two years for dental services we cannot use. Last May I found a dentist on their website and went there for a cleaning. Humana denied the claim saying they were out of network so we ended up having to pay out of pocket. I'm still fighting with Humana to get reimbursed. In September 2019, my husband went to a different dentist, referred to us by a Humana representative, that claim was too denied for the same reason! This is ridiculous. I cannot cancel or change providers until open enrollment. I'm so outdone.

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8:29 pm EST

Humana Denied pre cert for mom's rehab-state of ohio

My mom (#H64695236) had a severe stroke on Dec. 14, 2019, she was released to a rehab facility on Dec. 23, 2019.
I chose Humana as her primary Medicare advantage plan (offered as a Hoover company retiree) which would've taken effect on Jan. 1, 2020.

The rehab facility called Humana for a pre-cert for her continued rehab.
She was denied twice stating that she hadn't made any progress! everyone at the rehab facility was aghast at the fact that she was denied. The phrase used was "Humana is being DIRTY". Christ she graduated from being fed with a spoon to being able to use a straw, to me that is progress.

The poor woman had a softball size bleed on her brain, paralyzed on her left side and hadn't had any significant sleep for 10 days while in the hospital. Morphine didn't even help!

Humana must expect people to be doing cartwheels so soon after a stroke!

I am waiting on her medical records to file my first appeal, if that doesn't go our way, the next step will be filing a complaint with the Ohio Department of Insurance, and I have a message out to an insurance attorney.

Boy do I regret signing her up during open enrollment. I should have just left well enough alone and kept her strictly on Medicare A & B.

Game on Humana!

Lynn

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3:53 pm EST

Humana Humana medicare advantage gold

I had Humana Medicare Advantage Gold Plus for many years and in all instances, I never was able to use the Dental side of the plan. The Dental has a list of providers, but when you call them none of them accepts the plan. Even the Customer Service Rep. called many Dentists and was unable to locate one. She promised to find out more and called me back. That was two years ago, and she never called.
I decided to change companies, but reviewing the benefits all of these companies offer, I noticed that Humana offers a reimbursement through the medical side up to $1, 000 per year in dental procedure, and all you have to do is send the bills and they "would" reimburse the amount. I decided to take advantage of this complimentary benefit of Humana and submitted my claim to Medical. They in turned sent all the documents to Dental. Dental needed more information and finally they declined the claim, indicating the Dentist is not in their network. I already knew that there are no dentists on the Network, as I had tried to use it before without any success, as explained above. So, I called the medical and explained the situation to one person and after putting on hold for 20 minutes, another rep. appeared on my line asking me what she could help me with. Are you kidding me? I explained all of this, three times. I was put on hold and now you showed up on this line asking me why am I calling?
She knew I was frustrated, so she transferred me to a lady who at least had the courtesy of taking her time finding out more and offered to transfer me to the correct department that will be able to take care of this claim. Here comes a man with an Indian accent who did not allow me to explain any further and hang up on me. I called back to complain and asked her to tell me who I had been talking before and what was the name of the department that she had transferred me and I was treated such a lack of respect. She did not know.

This is Humana, they lie about dental, they lie about extra benefits like Dental Reimbursement.
Humana is a corrupted company, who does not assume responsibility.

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2:16 pm EST
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Humana Insurance

your company lied to me to get me to pay for coverage. Now that my coverage is over in January you are refusing to cancel. I have wrote to the BBB and i will continue to post negate commits til you cancel my services like i asked. If I get charge any more i will go to my local TV and radio stations and let them know how you spent hours on the phone with me telling me that this plan would cover all my med for my diabetes. than i order and had to pay an outrages co pay for them. I got stuck with this insurance for a year and now i want to cancel because i got a better insurance and you won't let me cancel this is [censored]. This company is committing fraud and should be shout down. I did not re enroll for another year of your [censored] leis and denials. I want this insurance cancelled A.S.A.P
A very pissed off customer right from the start of this insurance policy.

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12:00 pm EST

Humana Prescription drug program

On 11/05/2019 I enrolled my wife and myself to Humana Walmart Value RX.
I did this online at their website and received a confirmation that both applications were received. Received ID card for my wife but never received one for myself. They can't find me in the system and now they say it is too late to enroll. Have written proof of my received application.

Hal Bleich - [protected] [protected]@outlook.com

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heliosue
, US
Jan 01, 2020 11:14 am EST

Maybe you are better off without them. As of 01-01-2020, my Part D Plan with Humana was converted from a $29 per month plan to a $64 per month plan.I was unable to access my email for several months prior to this change and therefore, unable to receive email notifications. No other contact was attempted by Humana to get my agreement to this change. At the same time Humana made this change, they created another plan (much less costly), that is similar to my previous plan, but instead chose place me in their new Premier RX plan that is more than twice the cost of my previous plan. I regularly use three Tier 1 medications and my annual cost went from around $300 plus to $900 plus with the new plan.

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1:59 pm EST
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Humana Cancellation of prescription and to find out why

Plan: Medicare employer PPO ID H31871801 Plan #(80840)[protected] Diocese of Savannah My Name:
Clarence Mansell Card Issued 9/7/19

Problem: Script submitted by doctor and cancelled by Humana
Answer from 5 different reps of Human: In your computer it is noted that the script should be referred to my primary insurer which is medicare (you are secondary : Humana
Medicare PPO so..why has this script been refused when
others submitted (for other meds) has been accepted?
The med is a nasal spray and its name is also in you computer. Should I ask doctor to resubmit, prescribe a different med or what? Is this going to continue happening? Why can this not be resolved? Your reps have been very kind and tried to be helpful so this is not an
employee problem. Help!

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12:27 pm EST

Humana Customer serv.

After a long wait a young man answered that had no ideal what he was doing after a considerate amount of time. He tried to transfer my call and hung up on me. waited for call back that did not come. Called back on hold once again then a lady that kept asking the same questions over and over told her to write it down 20 min later she said to call my Doctor told her had refills but insurance stopped the pharmacy from refill total run around

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12:50 pm EDT

Humana Unethical behaviour

I called on 10.23.2019, and was assured that my order for Metformin 1000mg, placed on 10.21.2019 was being shipped out on 10.23.2019.
When I called today a representative, a supervisor, and a manager attempted duplicitous excuses and was unable to give me an assurance that the medication would be shipped out today.
Is Humana Pharmacy so inefficient that they are unable to process an order where there is a prescription on file, and a valid Credit Card on record, without having to make spurious excuses for delays?

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3:54 pm EDT

Humana Medication

I moved to Delray Beach, Florida 5 years ago, since my time here I had 8 back surgeries and 2 total knee replacements, I have been on medication since then. On March 5th 2019, my younger brother died, I went back to Pennsylvania to take care of the funeral and his estate. Came back 2 weeks later. In June I get a call my parents (both in their 80's) needed some help. My father had fallen and my mother tried to catch him, he fell on her and broke her hip. Now I have to go back to Pennsylvania to help them for 3 weeks. So I call humana and they give me something called a prescription override, so I can have enough medication until I get back, great. Fast forward to October, I decided to move back to Pennsylvania to look after my parents. Bought a house, have closing on Oct 15th. I get a rental truck for Thursday Oct. 10th, leaving early Saturday morning for the long drive back. Problem, my medication will run out and humana will not give me a vacation override, they say they will not do it more than once in a 12 month period, which was never explained to me before. I will be here on Oct. 11th, I cannot refill my prescription until the 14th, 3 FREAKIN DAYS! I was on the phone (over 4 ½ hours) and went to the local humana office to straighten this out. Their solution as told to me twice. On Oct 15th, after closing on my house in Pennsylvania, I should fly back to Florida just to refill a prescription. Are these people crazy? All I wanted was to have my prescription filled 3 DAYS early so I can move, they denied it. I even went as far as to call ahead in Pennsylvania to a pain center, but could not get an appt. until Oct 30th. So from the 15th to the 30th, I will have no pain medication. Pleaded with humana a for the 3 day override, they will not budge. I do not know what to do, I cannot have a script written in Florida filled in Pennsylvania. I will be without meds for 15 days and humana does not care! This is why people turn to getting other forms of help, weather it be legally or illegally. Humana is a heartless company and this is just a warning to whomever uses them, be careful, they do not care if you live or die.

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10:45 am EDT

Humana Repeated requests for eob — humana is ignoring me.

I am steve hagerman member h59711166-00 humana insurance company
Group x2550001.
I have made repeated requests by phone for my february 3, 2016 — eob (explanation of benefits). I first asked on july 3 — then august 14, then september 4 and 9. each time they tell me they will mail it in 2 weeks. the last time I got a reference # for our conversation which is: [protected].
I need humana to provide this record for me.
The va hospital has requested this information from me. it is unavailable on their web site and I need it. can you help me obtain this? I tried to attach the transcripts of my chats but the form will not allow. pdfs

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1:09 pm EDT

Humana Humana medicare advantage gold hmo

We are having issues with claims denying stating no referral is on file.

However, dr. Janis fowler-gulde is showing listed as the patient pcp, but claims deny stating services not authorized by network/primary care provider.

If dr. Gulde is not in the same network as the member's plan, the patient should not be allowed to select dr. Gulde as their pcp. We do not request a referral because dr. Gulde is showing as the patient pcp or authorization. Dr. Gulde effective date with humana is 01/01/2019.

Please advise how to get issued resolved, patients are getting upset and it's causing a financial hardship with the practice.

Thanks

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8:41 am EDT

Humana Dental

Before I booked an appointment for dental services, 11/13/2018. I called Humana for provider directory and verified benefits for the routine cleaning and filling that I would be receiving. Then almost a year later I get a bill from the dentist stating that Humana had denied the claim saying the dentist was not on the list. Of course, he was...I have the list they emailed me and he is on it. I spoke with Humana and they had the nerve to ask me to file an appeal, which I refused to do given that the dentist was on the list. Sent them the list they sent me just to prove it and did not hear back. Second visit to the same dentist a year later, and another bill. The dentist assured me before the work they were on the list as they had been before. Now I am billed $500. The short story is that now I filed a complaint with Medicare, Humana does everything possible to dissuade you from getting a claim paid. I don't get mad anymore...I file complaints, write scathing reviews and finally get resolve. Enough of this crap,

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4:50 pm EDT

Humana Provider service representatives

Date of Incident: 08/20/19

I am a Healthcare provider and calls Humana Monday - Friday for updates on claims or to find out why a claim denied. The representatives are so rude and often do not want to help with a simple claim status or questions regarding the processing of the claim. They will put you on a silent hold until you get tired and hang up or they will put you on hold with music and eventually hang up on you or wait till you end the call. I have requested o speak to a supervisor and have been put on hold or hung up on and have to keep calling for the same issue with no resolution or either call back and pretend I'm calling for a different reason and request to speak to a supervisor in provider services and that's how I end up speaking to a supervisor. This is so unprofessional on Humana's end on so many levels. I am not the only one with this problem, other billers have this same problem. I had this same problem with Humana when I was at a different company. Someone please look into this as soon as possible. The supervisors obviously has not done anything to change the way the representatives are doing their customers and clients. We have countless claims to follow up on with Humana but can't get through half of them because of this continued issue. Although we have Availity, it's not user friendly when it comes to Humana. It's not like we can send an inquiry through the portal like other payer plans that use Availity. This is causing us major issues trying to do our daily duties during our work day. I am solely speaking of the "Provider Services Department" that handles the claims. The number we call is 1-866-427-7478.

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Humana In-depth Review

Overview: Humana is a leading health insurance company that operates in the healthcare industry. With a rich history and background, Humana has established itself as a trusted provider of insurance and healthcare services.

Products and Services: Humana offers a comprehensive range of products and services to meet the diverse needs of its customers. These include health insurance plans, wellness programs, preventive care services, and resources for managing health and wellness. Each product and service is designed to provide the necessary coverage and support for individuals and families.

Customer Experience: Humana's website is easy to navigate and user-friendly, allowing customers to find the information they need quickly and efficiently. The company provides multiple customer support channels, including phone, email, and chat, ensuring that customers can easily reach out for assistance. Humana's customer service team is known for its prompt response time and high-quality service. Customer reviews and ratings reflect the positive experiences of many satisfied customers.

Coverage and Network: Humana offers extensive geographical coverage, ensuring that its services are available to a wide range of individuals and families. The company has a vast network of healthcare providers and facilities, making it convenient for customers to access the care they need. Humana's services are easily accessible and provide the necessary convenience for its customers.

Health Insurance Plans: Humana provides a variety of health insurance plans to cater to different needs. These plans offer comprehensive coverage, including deductibles, copayments, and out-of-pocket expenses. In-network and out-of-network coverage information is readily available, allowing customers to make informed decisions. Humana also offers specialized plans or options for specific healthcare needs, ensuring that individuals can find the right plan for their unique circumstances.

Wellness Programs and Resources: Humana offers a range of wellness programs and resources to promote and support the health and well-being of its customers. These programs include preventive care services and screenings, as well as tools and resources for managing health and wellness. Integration with wearable devices or mobile apps allows customers to track their progress and stay motivated.

Financial Stability: Humana has a strong financial stability and is well-regarded by independent financial rating agencies. The company's solid financial standing provides customers with confidence in its ability to meet its obligations. Humana has also been involved in recent mergers, acquisitions, and partnerships, further strengthening its position in the industry.

Member Satisfaction: Humana consistently receives high member satisfaction ratings and positive feedback. Surveys and studies measuring member experience and satisfaction demonstrate the company's commitment to providing excellent service. Humana's complaint resolution process is transparent and efficient, ensuring that any issues or concerns are addressed promptly.

Additional Benefits and Features: In addition to its core offerings, Humana provides additional benefits and features to enhance the customer experience. These include prescription drug coverage and pharmacy services, as well as dental, vision, and other supplemental coverage options. Value-added services such as telemedicine or nurse hotlines further contribute to the overall value provided by Humana.

Privacy and Security: Humana prioritizes the privacy and security of its customers' personal and medical information. The company has robust measures in place to protect sensitive data and complies with industry regulations and standards. Customers can trust that their information is safe and secure with Humana.

Pros and Cons:

  • Pros:
    • Comprehensive range of products and services
    • User-friendly website and easy navigation
    • Responsive and high-quality customer service
    • Extensive coverage and network of healthcare providers
    • Diverse health insurance plans to meet different needs
    • Wellness programs and resources for managing health and wellness
    • Strong financial stability and positive ratings
    • High member satisfaction and transparent complaint resolution process
    • Additional benefits and features for enhanced value
    • Commitment to privacy and security
  • Cons:
    • Pricing may be higher compared to some competitors
    • Availability of services may vary by location

Conclusion: Humana is a reputable health insurance company that offers a wide range of products and services to meet the diverse needs of its customers. With a user-friendly website, responsive customer service, and extensive coverage and network, Humana provides a positive customer experience. The company's commitment to wellness programs, financial stability, member satisfaction, and privacy and security further enhance its value. While pricing may be higher compared to some competitors and availability of services may vary, Humana remains a reliable choice for individuals and families seeking comprehensive health insurance and healthcare solutions.

Recommendation: For potential customers considering Humana's services, it is recommended to thoroughly review the available health insurance plans and compare them with competitors in terms of pricing, coverage, and customer experience. Additionally, assessing individual healthcare needs and preferences will help determine if Humana's specialized plans or options align with specific requirements. Overall, Humana's strong reputation, commitment to customer satisfaction, and comprehensive offerings make it a viable choice for those seeking reliable health insurance and wellness solutions.

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Phone numbers

+1 (800) 486-2620 +1 (800) 448-6262 More phone numbers

Website

www.humana.com

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